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Dáil Question on GPs charging medical card holders for blood tests January 2013


DÁIL QUESTION addressed to the Minister of State at the Department of Health (Mr White) by Deputy Anthony Lawlor

for WRITTEN ANSWER on 16/01/2013

* To ask the Minister for Health the number of general practitioners who have been reported to the Health Service Executive for charging medical card holders for blood tests; and if he will make a statement on the matter.


In circumstances where the taking of blood is necessary to either (a) assist in the process of diagnosing a patient or (b) monitor a diagnosed condition, General Practitioners (GPs) may not charge patients if they are eligible for free GMS services under the Health Act, 1970, as amended.  It is the contracted responsibility of GPs to provide proper and necessary treatment to eligible persons. If part of that proper and necessary treatment includes routine phlebotomy, GPs must provide such services free of charge under the terms of their General Medical Services (GMS) contract.

The HSE has written to GP contract holders and clarified the position in relation to this matter and has also communicated its position to the Irish Medical Organisation.

As of October 2012, the HSE had received formal complaints that 14 GPs had allegedly charged patients for phlebotomy services.  Where evidence had emerged of GPs charging patients for routine phlebotomy services, the HSE wrote to the GP contractors advising them that by charging GMS patients they were in breach of the GMS contract and that persistence in the practice of charging patients could have contractual implications, including adjustments to routine payments such as nurse subsidies.  Of the 14 GPs who were reported to the HSE Primary Care Units for charging for phlebotomy services in October 2012, at least 2 GPs refunded patients. In another instance, a new GP joined the practice of one of the GPs and charging for phlebotomy services has since ceased at that practice. 2 of the other GPs were found to have charged legitimately as the blood tests were not ‘routine’. The HSE is continuing to address this issue.

The HSE is also continuing to advise eligible patients who believe they have been inappropriately charged by a GP for routine phlebotomy services, to seek a refund from the GPs in question.